Provider Demographics
NPI:1134317480
Name:ZLATKOV, JORDANKA DANOVA
Entity Type:Individual
Prefix:
First Name:JORDANKA
Middle Name:DANOVA
Last Name:ZLATKOV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 HAMPSHIRE RD APT 26
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2349
Mailing Address - Country:US
Mailing Address - Phone:805-497-6446
Mailing Address - Fax:
Practice Address - Street 1:11429 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-3143
Practice Address - Country:US
Practice Address - Phone:323-877-6034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT 6839225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant